February 2021
Lessons Learned: Challenges and Successes of New York’s Behavioral Health Provider Agencies During the Pandemic
The Coalition for Behavioral Health calls on the State to provide additional funding to address revenue shortfalls and offers recommendations on how New York can be prepared for future crises.
New York, NY (February 19, 2021)– Today, The Coalition for Behavioral Health (The Coalition), the umbrella advocacy association of New York’s behavioral health community, released “Lessons Learned: Challenges and Successes of New York’s Behavioral Health Provider Agencies During the Pandemic,” a report detailing lessons learned by New York’s behavioral health sector during the first wave of the COVID-19 pandemic, and offering recommendations on how New York State can be better prepared for future crises. Behavioral health agencies lost an average of $521,000 due to having fewer billable visits during the first months of the pandemic because they couldn’t see many clients in-person, and had to pay for unexpected expenses including PPE and technology upgrades. At the same time, the pandemic sparked a 77 percent increase in demand for behavioral health services.
The report highlights how The Coalition’s over 100 non-profit community-based behavioral health agencies that serve more than 600,000 New Yorkers adapted to the COVID-19 shutdown, and the importance of increased funding to build additional capacity to meet the anticipated need for more mental health and addiction treatment services due to the adverse impacts of the pandemic.
The mid-March shutdown forced non-profit agencies to drastically change how they provide vital safety net services, which brought most in-person interactions to a halt. Despite a lack of preparedness for a viral pandemic and limited resources, many agencies successfully pivoted to offering telehealth services, while continuing to operate and staff essential community treatment and congregate residential programs for New Yorkers who have serious mental health and addiction conditions.
Agencies were able to maintain a strong network of mental health and addiction treatment services throughout the first wave of the pandemic despite the challenges. However, the pandemic has left many in a precarious financial position.
The report makes the following recommendations for strengthening the behavioral health sector so that it can meet the increased need for behavioral health services brought on by the pandemic and be better prepared for future crisis events:
- New York State and New York City should partner with the behavioral health sector to develop a concrete crisis plan that addresses technology and equipment needs, management and workforce training, and alternative scenarios for care delivery based on foreseeable crisis conditions.
- New York State regulatory and funding agencies—Department of Health (DOH), Office of Mental Health (OMH), Office of Addiction Services and Supports (OASAS) and Office for Persons with Developmental Disabilities (OPWDD)—should promulgate consistent, aligned protocols around use of telehealth, client safety and other issues to guide the community behavioral health sector.
- Behavioral health agencies serving our most vulnerable New Yorkers with serious conditions should receive funding or rate enhancements to shrink the digital divide–a treatment barrier for low-income New Yorkers—by offering training/support to use visual technologies and smartphones/tablets with robust internet plans to facilitate remote service delivery.
- Workforce problems that have existed for some time in the behavioral health sector need to be addressed with a multipronged and thoughtful approach that includes higher salaries and career pathways. A strategy for emergency staffing, when necessary, needs to be in place to ensure client safety going forward.
- The behavioral health sector must be financially supported to deliver vital safety net services. Crisis-related costs should not be pushed down to community agencies that have the least capacity to absorb them. NYS must provide additional financial resources to cover expenditures for personal protective equipment (PPE), quarantining residential clients, workforce incentive pay, community outreach and lost revenue. The agencies should be reimbursed for these costs, or have their rates enhanced to compensate them.
“The COVID-19 pandemic forced behavioral health agencies to turn on a dime and quickly re-imagine how they deliver services to hundreds of thousands of the most vulnerable New Yorkers. Despite limited resources, our members were heroically able to continue providing life-saving mental health and addiction treatment services,” said Amy Dorin, President and CEO of the Coalition for Behavioral Health. “This came at a tremendous cost to service providers, who had to pay out of pocket for the technology to make telehealth work and PPE to keep clients and staff safe. New York will be feeling the effects of the pandemic for years to come, and the City and State should use this as an opportunity to work with the behavioral health sector to strengthen our community-based providers so they can meet the increased need for their services and be prepared for the next crisis.”
“The pandemic presented an unprecedented challenge for Behavioral Health agencies. We needed to be there for the New Yorkers who rely on us and respond to a groundswell of new needs created by the pandemic, while delivering services in a way that kept our staff and our clients safe,” said Mitchell Netburn, Chair of the Coalition for Behavioral Health, and President and CEO of Samaritan Daytop Village. “The lessons we’ve learned over the past 10 months should guide the behavioral health community as we tackle future crises, including the lasting impacts of the pandemic. We look forward to working with the City and State to ensure we can continue to effectively meet New York’s behavioral health needs.”
The report includes interviews with several leading Behavioral Health agencies that uncovered some of the challenges faced, and best practices that helped keep clients and staff safe. At the height of the pandemic, the Institute for Community Living (ICL) had 126 employees sick with COVID, and 260 quarantining due to exposure. The hardest hit were ICL’s 24/7-staffed homeless shelters. Workers from supportive housing and other programs stepped up to help, volunteering for overtime shifts and putting their own health at risk as government failed to provide adequate support.
“We were able to overcome many of the challenges presented to us by COVID, thanks to the dedication, bravery and ingenuity of our staff, but the pandemic has severely drained our resources, which were already stretched thin”, said David Woodlock, Vice Chair of the Coalition for Behavioral Health and President and CEO of ICL. “Workers went into residences without PPE, when it was not available, at great risk to their health. We could not understand how government regulators could require that all residential staff use PPE and not pay for it. Additionally, we had to invest heavily in technology so we could continue to provide services in a way that kept our clients and staff safe.”
By the second wave of COVID infections, ICL had a well-tested crisis management model in place. ICL’s senior management team met daily to track COVID cases diagnosed among their clients and staff, review new government directives and monitor the efficacy of the agency’s efforts to continue offering services, while reducing COVID infections. ICL’s proactive response helped them flatten the curve a week before NYC, even while serving a very high-risk population.
“The need for mental health services will continue to grow, even after every New Yorker has been vaccinated. The State needs to begin planning with Behavioral Health agencies now and give us the resources and regulatory flexibility we will need to address the looming mental health crisis brought on by the pandemic,” Woodlock added.
Funding for this report was provided by The New York Community Trust’s NYC COVID-19 Response and Impact Fund (a multi-funder collaborative).
To view report titled “Lessons Learned: Challenges and Successes of New York’s Behavioral Health Provider Agencies During the Pandemic,” click here.